Boston Road Medical Practice PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BOSTON ROAD MEDICAL PRACTICE PC

Practice address

2190 Boston Rd
Suite 1N
Bronx, NY 10462-1201

Phone

(718) 863-8663

Fax

(718) 863-8261

NPI assigned

Jan 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Valeri Kazakov, MDNPI 1487633772

Title

Owner of the Medical Practice

Phone

(718) 863-8663

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Valeri I Kazakov, MD

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1487633772
  Medicare reassignment Care Compare group NPD Authorized official
• Mladen Solar, M.D.

  • Cardiovascular Disease Physician
  • Brooklyn, NY
  • NPI 1780677823
  Medicare reassignment Care Compare group NPD
• Daniel S Gurell, MD

  • Diagnostic Radiology Physician
  • Bronx, NY
  • NPI 1336164029
  Medicare reassignment NPD
• Oksana Berkovich, MD

  • Internal Medicine Physician
  • Bronx, NY
  • NPI 1245291269
  NPD
• Anna Potash, M.D.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1598760019
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283817600000",
    "number": "1306816285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 AMANDA LN",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108043313",
            "telephone_number": "718-863-8621",
            "fax_number": "718-863-8261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 BOSTON RD",
            "address_2": "SUITE 1N",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104621201",
            "telephone_number": "718-863-8663",
            "fax_number": "718-863-8261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON ROAD MEDICAL PRACTICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2010-09-07",
        "status": "A",
        "authorized_official_last_name": "KAZAKOV",
        "authorized_official_first_name": "VALERI",
        "authorized_official_title_or_position": "OWNER OF THE MEDICAL PRACTICE",
        "authorized_official_telephone_number": "718-863-8663",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023196",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Camille Bosquet, PA
• Nikolozi Bostashvili
• Boston Pediatrics PLLC
• Boston Pediatrics, PLLC
• Boston Road Care LLC
• Boston Road Neighborhood Medical Care PC
• Boston Road Pharmacy Corp.
• Hannah M Boston, LMSW
• Natashia Vanessa Boston, M.S SPECIAL EDUCATIO
• Tonika Boston, LMSW

• Internal Medicine Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.